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Research article:
Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis
Reference:
Kathryn M Abel, Holly Hope, Eleanor Swift, Rosa Parisi, Darren M Ashcroft, Kyriaki Kosidou, Cemre Su Osam, Christina Dalman, Matthias Pierce(2019) Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis. Lancet Public Health, doi: doi: https://doi.org/10.1016/S2468-2667(19)30059-3
- Link to article
- Abstract
- Background Little information exists about the prevalence of children exposed to maternal mental illness. We aimed to estimate the prevalence of children and adolescents exposed to maternal mental illness in the UK between 2005 and 2017 using primary care data. Methods In this national retrospective cohort study, we included children aged 0–16 years born between Jan 1, 1991, and Dec 31, 2015, who were linked to their mothers and registered on the primary care Clinical Practice Research Datalink (CPRD) between 2005 and 2017. We extracted data on diagnosis, symptoms, and therapy from the CRPD to define the following maternal mental illnesses: depression, anxiety, non-affective psychosis, affective psychosis, eating disorders, personality disorders, alcohol misuse disorder, and substance misuse disorder. We also extracted data on socioeconomic status from the Index of Multiple Deprivation 2010 and data on ethnicity from the Hospital Episode Statistics dataset. The main outcome was prevalence of maternal mental illness. Prevalence was calculated for each 2-year period of childhood (from age 0–<2 to 14–<16 years) using marginal predictions from a logistic regression model. We used survival analysis to estimate the incidence and cumulative risk of children experiencing maternal mental illness by age 16 years. Findings We identified 783 710 children registered in the UK CPRD mother-baby link database, and included 547 747 children (381 685 mothers) in our analysis. Overall prevalence of maternal mental illness was 23·2% (95% CI 23·1–23·4), which increased during childhood (21·9%, 21·7–22·1 among the 0–<2 year age group vs 27·3%, 26·8–27·8 among the 14–<16 year age group). Depression and anxiety were the most prevalent maternal mental illnesses. The proportion of children exposed to maternal mental illness increased from 22·2% (21·9–22·4) between 2005 and 2007 to 25·1% (24·8–25·5) between 2015 and 2017. Geographically, the highest prevalence of maternal mental illness was observed in Northern Ireland (29·8%, 29·0–30·5). In England, prevalence of maternal mental illness was highest among children in the most deprived areas (28·3%, 27·8–28·8). The incidence of maternal mental illness was highest between 0–3 months (26·7 per 100 person years, 26·4–27·1). By age 16 years, the cumulative risk of maternal mental illness was 53·1% (52·8–53·3). Interpretation One in four children aged 0–16 years are exposed to maternal mental illness and the prevalence of diagnosed and treated maternal mental illness is increasing. Policy makers and commissioners should consider this information and channel resources to target individuals in greatest need. Funding The European Research Council and the National Institute for Health Research.
- Author for correspondence
- Holly Hope
- Email for correspondence
- holly.hope@manchester.ac.uk
Code list: res76: Personality disorders
122 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 28L..00 | Read | O/E - impulsive behaviour | symptom | res76: Personality disorders | |||
| E21..00 | Read | Personality disorders | diagnostic | res76: Personality disorders | |||
| E210.00 | Read | Paranoid personality disorder | diagnostic | res76: Personality disorders | |||
| E211.00 | Read | Affective personality disorder | diagnostic | res76: Personality disorders | |||
| E211000 | Read | Unspecified affective personality disorder | diagnostic | res76: Personality disorders | |||
| E21..11 | Read | Neurotic personality disorder | diagnostic | res76: Personality disorders | |||
| E211100 | Read | Hypomanic personality disorder | diagnostic | res76: Personality disorders | |||
| E211300 | Read | Cyclothymic personality disorder | diagnostic | res76: Personality disorders | |||
| E211z00 | Read | Affective personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E212.00 | Read | Schizoid personality disorder | diagnostic | res76: Personality disorders | |||
| E212000 | Read | Unspecified schizoid personality disorder | diagnostic | res76: Personality disorders | |||
| E212200 | Read | Schizotypal personality | diagnostic | res76: Personality disorders | |||
| E212z00 | Read | Schizoid personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E213.00 | Read | Explosive personality disorder | diagnostic | res76: Personality disorders | |||
| E213.11 | Read | Aggressive personality | diagnostic | res76: Personality disorders | |||
| E214.00 | Read | Compulsive personality disorders | diagnostic | res76: Personality disorders | |||
| E214000 | Read | Anankastic personality | diagnostic | res76: Personality disorders | |||
| E214100 | Read | Obsessional personality | diagnostic | res76: Personality disorders | |||
| E214.11 | Read | Anancastic personality | diagnostic | res76: Personality disorders | |||
| E214z00 | Read | Compulsive personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E215.00 | Read | Histrionic personality disorders | diagnostic | res76: Personality disorders | |||
| E215000 | Read | Unspecified histrionic personality disorder | diagnostic | res76: Personality disorders | |||
| E215100 | Read | Munchausen's syndrome | diagnostic | res76: Personality disorders | |||
| E215.11 | Read | Hysterical personality disorders | diagnostic | res76: Personality disorders | |||
| E215200 | Read | Emotionally unstable personality | diagnostic | res76: Personality disorders | |||
| E215z00 | Read | Histrionic personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E216.00 | Read | Inadequate personality disorder | diagnostic | res76: Personality disorders | |||
| E216.11 | Read | Asthenic personality | diagnostic | res76: Personality disorders | |||
| E216.12 | Read | Dependent personality | diagnostic | res76: Personality disorders | |||
| E216.13 | Read | Labile personality | diagnostic | res76: Personality disorders | |||
| E217.00 | Read | Antisocial or sociopathic personality disorder | diagnostic | res76: Personality disorders | |||
| E217.11 | Read | Amoral personality | diagnostic | res76: Personality disorders | |||
| E21y.00 | Read | Other personality disorders | diagnostic | res76: Personality disorders | |||
| E21y000 | Read | Narcissistic personality disorder | diagnostic | res76: Personality disorders | |||
| E21y100 | Read | Avoidant personality disorder | diagnostic | res76: Personality disorders | |||
| E21y200 | Read | Borderline personality disorder | diagnostic | res76: Personality disorders | |||
| E21y300 | Read | Passive-aggressive personality disorder | diagnostic | res76: Personality disorders | |||
| E21y400 | Read | Eccentric personality disorder | diagnostic | res76: Personality disorders | |||
| E21y500 | Read | Immature personality disorder | diagnostic | res76: Personality disorders | |||
| E21y600 | Read | Masochistic personality disorder | diagnostic | res76: Personality disorders | |||
| E21y700 | Read | Psychoneurotic personality disorder | diagnostic | res76: Personality disorders | |||
| E21y711 | Read | Neurotic personality | diagnostic | res76: Personality disorders | |||
| E21yz00 | Read | Other personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E21z.00 | Read | Personality disorder NOS | diagnostic | res76: Personality disorders | |||
| E21z.11 | Read | Psychopathic personality | diagnostic | res76: Personality disorders | |||
| E2C..00 | Read | Disturbance of conduct NEC | symptom | res76: Personality disorders | |||
| E2C0.00 | Read | Aggressive unsocial conduct disorder | symptom | res76: Personality disorders | |||
| E2C3100 | Read | Pathological gambling | diagnostic | res76: Personality disorders | |||
| E2C4.00 | Read | Mixed disturbance of conduct and emotion | symptom | res76: Personality disorders | |||
| Eu21.18 | Read | [X]Schizotypal personality disorder | diagnostic | res76: Personality disorders | |||
| Eu34011 | Read | [X]Affective personality disorder | diagnostic | res76: Personality disorders | |||
| Eu34012 | Read | [X]Cycloid personality | diagnostic | res76: Personality disorders | |||
| Eu34013 | Read | [X]Cyclothymic personality | diagnostic | res76: Personality disorders | |||
| Eu34112 | Read | [X]Depressive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu6..00 | Read | [X]Disorders of adult personality and behaviour | diagnostic | res76: Personality disorders | |||
| Eu60.00 | Read | [X]Specific personality disorders | diagnostic | res76: Personality disorders | |||
| Eu60000 | Read | [X]Paranoid personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60011 | Read | [X]Expansive paranoid personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60013 | Read | [X]Querulant personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60014 | Read | [X]Sensitive paranoid personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60100 | Read | [X]Schizoid personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60200 | Read | [X]Dissocial personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60211 | Read | [X]Amoral personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60212 | Read | [X]Antisocial personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60213 | Read | [X]Asocial personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60214 | Read | [X]Psychopathic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60215 | Read | [X]Sociopathic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60300 | Read | [X]Emotionally unstable personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60311 | Read | [X]Aggressive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60312 | Read | [X]Borderline personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60313 | Read | [X]Explosive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60400 | Read | [X]Histrionic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60411 | Read | [X]Hysterical personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60412 | Read | [X]Psychoinfantile personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60500 | Read | [X]Anankastic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60511 | Read | [X]Compulsive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60512 | Read | [X]Obsessional personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60513 | Read | [X]Obsessive-compulsive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60600 | Read | [X]Anxious [avoidant] personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60700 | Read | [X]Dependent personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60711 | Read | [X]Asthenic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60712 | Read | [X]Inadequate personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60713 | Read | [X]Passive personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60714 | Read | [X]Self defeating personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60800 | Read | [X]Addictive personality | diagnostic | res76: Personality disorders | |||
| Eu60y00 | Read | [X]Other specific personality disorders | diagnostic | res76: Personality disorders | |||
| Eu60y11 | Read | [X]Eccentric personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60y12 | Read | [X]Haltlose type personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60y13 | Read | [X]Immature personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60y14 | Read | [X]Narcissistic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60y16 | Read | [X]Psychoneurotic personality disorder | diagnostic | res76: Personality disorders | |||
| Eu60z00 | Read | [X]Personality disorder, unspecified | diagnostic | res76: Personality disorders | |||
| Eu60z11 | Read | [X]Character neurosis NOS | diagnostic | res76: Personality disorders | |||
| Eu60z12 | Read | [X]Pathological personality NOS | diagnostic | res76: Personality disorders | |||
| Eu61.00 | Read | [X]Mixed and other personality disorders | diagnostic | res76: Personality disorders | |||
| Eu62.00 | Read | [X]Enduring personality change not attrib to brain damag/dis | diagnostic | res76: Personality disorders | |||
| Eu62000 | Read | [X]Enduring personality change after catastrophic experience | diagnostic | res76: Personality disorders | |||
| Eu62011 | Read | [X]Personality change after concentration camp experiences | diagnostic | res76: Personality disorders | |||
| Eu62012 | Read | [X]Personality change after disasters | diagnostic | res76: Personality disorders | |||
| Eu62013 | Read | [X]Personality change aft prolong captiv+possib/being killed | diagnostic | res76: Personality disorders | |||
| Eu62014 | Read | [X]Personlty chang aft expos life-threat sit/victim/terrorsm | diagnostic | res76: Personality disorders | |||
| Eu62015 | Read | [X]Personality change after torture | diagnostic | res76: Personality disorders | |||
| Eu62100 | Read | [X]Enduring personality change after psychiatric illness | diagnostic | res76: Personality disorders | |||
| Eu62y00 | Read | [X]Other enduring personality changes | diagnostic | res76: Personality disorders | |||
| Eu62y11 | Read | [X]Chronic pain personality syndrome | diagnostic | res76: Personality disorders | |||
| Eu62z00 | Read | [X]Enduring personality change, unspecified | diagnostic | res76: Personality disorders | |||
| Eu63.00 | Read | [X]Habit and impulse disorders | diagnostic | res76: Personality disorders | |||
| Eu63000 | Read | [X]Pathological gambling | diagnostic | res76: Personality disorders | |||
| Eu63011 | Read | [X]Compulsive gambling | diagnostic | res76: Personality disorders | |||
| Eu63100 | Read | [X]Pathological fire-setting | diagnostic | res76: Personality disorders | |||
| Eu63200 | Read | [X]Pathological stealing | diagnostic | res76: Personality disorders | |||
| Eu63300 | Read | [X]Trichotillomania | diagnostic | res76: Personality disorders | |||
| Eu63y00 | Read | [X]Other habit and impulse disorders | diagnostic | res76: Personality disorders | |||
| Eu63z00 | Read | [X]Habit and impulse disorder, unspecified | diagnostic | res76: Personality disorders | |||
| Eu6y.00 | Read | [X]Other disorders of adult personality and behaviour | diagnostic | res76: Personality disorders | |||
| Eu6y000 | Read | [X]Elaboration of physical symptoms for psychological reason | diagnostic | res76: Personality disorders | |||
| Eu6y100 | Read | [X]Intent product/feign of symptom/disab eith physical/psych | diagnostic | res76: Personality disorders | |||
| Eu6y111 | Read | [X] Munchausens syndrome | diagnostic | res76: Personality disorders | |||
| Eu6y200 | Read | [X]Munchausen's by proxy | diagnostic | res76: Personality disorders | |||
| Eu6y300 | Read | [X]Factitious disorder | diagnostic | res76: Personality disorders | |||
| Eu6yy00 | Read | [X]Other specified disorders of adult personality/behaviour | diagnostic | res76: Personality disorders | |||
| Eu6z.00 | Read | [X]Unspecified disorder of adult personality and behaviour | diagnostic | res76: Personality disorders |
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